House Passes Bill to Repeal the Affordable Care Act

House Passes Bill to Repeal the Affordable Care Act


On Thursday, May 4th, the U.S. House of Representatives passed a bill to repeal some key portions of the Affordable Care Act (the ACA).  The bill now goes to the Senate for a vote.

The bill essentially guts a number of major provisions of the ACA, including:

  • Ending the tax penalty against individuals without health coverage.
  • Ending the Medicaid expansion funding provision of the ACA.
  • Replacing the ACA’s cost-sharing subsidies based on consumers’ incomes and premium costs with tax credits that increase as consumers age.
  • Repealing taxes on the wealthy, insurers, and drug and medical device makers.

The bill also provides that consumers who let their coverage lapse for more than 63 days in a year would be required to pay a 30% surcharge to reinstate their insurance coverage.  This includes consumers with pre-existing medical conditions.  Moreover, the bill includes some provisions designed to rein in spending.  For example, the bill would change Medicaid from an open-ended program to one that gives states a fixed amount of money per person per year.  States would, however, receive $8 billion over five years to finance high-risk pools that cover those individuals with pre-existing conditions, and states would get $130 billion over a decade to help people afford coverage.  And the bill retains one of the most popular portions of the ACA, allowing children to remain on their parents’ insurance plans until the age of 26.


If passed by the Senate without major amendments, this bill could have a significant impact on hospitals and other providers.  The provision to end Medicaid expansion funding, in particular, could result in more uninsured patients seeking care at hospital emergency rooms.  The Congressional Budget Office (CBO) estimates that a previous version of the bill would result in 24 million people losing their health insurance by 2026. The CBO is expected to score the current version of the bill in the next week.

However, it is unlikely that the bill will be passed by the Senate without amendment.  It remains to be seen whether the current bill will be recognizable when (and if) it passes the Senate.  Nevertheless, most commentators agree that the House’s action is a significant step towards President Trump’s campaign promise to “repeal and replace ObamaCare.” 

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